Background <p>Prior studies have suggested that theta burst stimulation (TBS) may be a promising intervention for the rehabilitation of aphasia after stroke. However, the results of these investigations have been inconsistent, with no definitive consensus on its efficacy and safety. Given the inconclusive nature of the existing evidence, this study aims to conduct a comprehensive and systematic review to evaluate the therapeutic effects of TBS on aphasia in stroke patients.</p> Methods <p>We will perform an extensive search of eight online databases from their inception to August 1, 2024, to identify relevant randomized controlled trials (RCTs) that examine the impact of TBS on aphasia in stroke patients. The primary outcome will be the severity of aphasia, assessed using a suite of standardized evaluation tools. Secondary outcomes will include measures of naming, repetition, comprehension, spontaneous speech, aphasia quotient, quality of life, and documentation of adverse events. The review process will involve rigorous study selection, data extraction, risk of bias assessment, and evaluation of the certainty of evidence by two independent reviewers. Data synthesis and statistical analysis will be conducted using Review Manager (RevMan) software, version 5.3. If significant heterogeneity is not detected among the studies, a meta-analysis will be performed. Otherwise, a narrative qualitative summary will be provided. The quality of evidence will be assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system.</p> Discussion <p>This study will be the first systematic review to comprehensively synthesize the existing evidence regarding the application of TBS in the treatment of aphasia in stroke patients. The findings are expected to provide valuable insights for clinicians and policymakers, facilitating the development of more equitable and high-quality healthcare services for this patient population.</p> Systematic review registration <p>PROSPERO CRD42024521347.</p>